Cervical coinfection with human papillomavirus (HPV) types as a predictor of acquisition and persistence of HPV infection

Interest in coinfection with multiple types of human papillomavirus (HPV) h as increased in response to the possibility of vaccination and the discover y that the host immune response appears to be mainly type specific. This st udy attempts to document the occurrence of coinfection with multiple HPV ty pes and to determine whether these coinfections predicted acquisition or pe rsistence of other HPV types in a prospective cohort of women in Brazil. Mu ltiple HPV types were detected at the same visit in one-fifth of all women who tested positive for HPV at any time. Acquisition of an HPV infection wa s more likely among women with any HPV type detected on study entry. Persis tence of HPV infection, the true precursor of cervical abnormalities, was i ndependent of coinfection with other HPV types. Given the increasing promin ence of HPV vaccination as a potential preventive approach, it is imperativ e that additional insights on cross-type protection be obtained from longer -term longitudinal investigations.